Journal article
Intra-Arterial Infusion of Autologous Bone Marrow Mononuclear Cells in Patients With Moderate to Severe Middle Cerebral Artery Acute Ischemic Stroke
Cell transplantation, Vol.21(1_suppl), pp.S13-S21
01/01/2012
DOI: 10.3727/096368912X612512
PMID: 22507676
Abstract
Transplantation of autologous bone marrow mononuclear cells (BMMCs) has been proven safe in animal and human studies. However, there are very few studies in stroke patients. In this study, intra-arterial autologous BMMCs were infused in patients with moderate to severe acute middle cerebral artery infarcts. The subjects of this study included 20 patients with early or late spontaneous recanalization but with persistent deficits, in whom treatment could be initiated between 3 and 7 days after stroke onset. Mononuclear cells were isolated from bone marrow aspirates and infused at the proximal middle cerebral artery of the affected hemisphere. Safety analysis (primary endpoint) during the 6-month follow-up assessed death, any serious clinical events, neurological worsening with >= 4-point increase in National Institutes of Health Stroke Scale (NIHSS) scores, seizures, epileptogenic activity on electroencephalogram, and neuroimaging complications including new ischemic, hemorrhagic, or neoplastic lesions. Satisfactory clinical improvement (secondary endpoint) at 90 days was defined according to the pretreatment NIHSS scores as follows: modified Rankin Scale score of 0 in patients with NIHSS <8, modified Rankin Scale scores of 0-1 in patients with NIHSS 8-14, or modified Rankin Scale scores 0-2 in patients with NIHSS >14. Good clinical outcome was defined as mRS <= 2 at 90 days. Serial clinical, laboratory, electroencephalogram, and imaging evaluations showed no procedure-related adverse events. Satisfactory clinical improvement occurred in 6/20 (30%) patients at 90 days. Eight patients (40%) showed a good clinical outcome. Infusion of intra-arterial autologous BMMCs appears to be safe in patients with moderate to severe acute middle cerebral artery strokes. No cases of intrahospital mortality were seen in this pilot trial. Larger prospective randomized trials are warranted to assess the efficacy of this treatment approach.
Details
- Title: Subtitle
- Intra-Arterial Infusion of Autologous Bone Marrow Mononuclear Cells in Patients With Moderate to Severe Middle Cerebral Artery Acute Ischemic Stroke
- Creators
- Mauricio A. G. Friedrich - Hosp Sao Lucas, Porto Alegre, RS, BrazilMaurer P. Martins - Hospital Mãe de DeusMariana D. Araujo - Hospital São Lucas da PUCRSCharles Klamt - Hospital São Lucas da PUCRSLeonardo Vedolin - Hospital São Lucas da PUCRSBernardo Garicochea - Hospital São Lucas da PUCRSEduardo F. Raupp - Hospital São Lucas da PUCRSJeber Sartori El Ammar - Hospital São Lucas da PUCRSDenise Cantarelli Machado - Hospital São Lucas da PUCRSJaderson C. da Costa - Hospital São Lucas da PUCRSRaul G. Nogueira - Harvard UniversityPaulo Henrique Rosado-de-Castro - Universidade Federal do Rio de JaneiroRosalia Mendez-Otero - Universidade Federal do Rio de JaneiroGabriel R. de Freitas - Universidade Federal do Rio de Janeiro
- Resource Type
- Journal article
- Publication Details
- Cell transplantation, Vol.21(1_suppl), pp.S13-S21
- DOI
- 10.3727/096368912X612512
- PMID
- 22507676
- NLM abbreviation
- Cell Transplant
- ISSN
- 0963-6897
- eISSN
- 1555-3892
- Publisher
- Sage
- Number of pages
- 9
- Grant note
- Ministry of Health 552201/2005-7 / Ministry of Science and Technology of Brazil
- Language
- English
- Date published
- 01/01/2012
- Academic Unit
- Radiology
- Record Identifier
- 9985143554102771
Metrics
1 Record Views